THE EFFECTIVENESS OF INTERVENTION MODEL ON GLAUCOMA HEALTH SERVICE ACCESS AMONG PEOPLE OVER 40 YEARS OLD IN HUE CITY

Abstract

Introduction: Glaucoma is the leading cause of irreversible blindness and the second leading cause of blindness in general. Early detection and timely treatment help reduce the progression of the disease, indirectly limit the economic burden and ensure the quality of life for patients. Currently, access to glaucoma prevention medical services is difficult in developing countries due to limited access to eye care facilities. Objective: To assess the effectiveness of interventions to increase the access to glaucoma services of people over 40 years old in Hue city. Methods: Applied the study design for community intervention with the comparison between intervened and control groups. Results: Our intervention approach included 3 groups of activities: active communication to change behaviors, medical staff training to improve knowledge and practice, treatment and management for glaucoma patients, suspected glaucoma cases or those at risk factors for glaucoma. Results showed that, in the intervention group, the percentage of people with good knowledge increased from 2.5% to 49.1%, good attitude increased from 3.4% to 51.6%, good practice increased from 2.3% to 46.3%. Regarding the improvement of access to glaucoma services, the proportion of people having annual eye exams increased from 30.7% to 49.9%, the figure for having glaucoma screening increased from 26.9% to 59.0%, proportion of those who were glaucoma patients, suspected and at risk with glaucoma that regularly monitored is 90.8%, percentage of those completely followed medication used instruction is 60%. In terms of the effective of the intervention program, the change in glaucoma good practice is 43.2%, the change in having annual eye examination is 46.7%, and the change in having glaucoma screening is 57.7%. Ability to access glaucoma screening services increased by 8 (95%CI: 5.31-12.04, p<0.05) times, good knowledge increased by 3.67 (95%CI: 1.47-9.1, p<0.05) times, good attitude increased by 2.13 (95%CI: 1.02-4.43, p<0.05) times and practice increased by 2.39 (95%CI: 1.42-1.56, p<0.05) times compared to the control groups. Conclusions: There is need to enhance the communication and education on glaucoma for the people, improve the knowledge and ability to detect glaucoma for local health care workers within the existing capacity of the primary health care facility, closely coordinate between medical facilities at different levels in providing glaucoma medical services for all people. Key words: glaucoma, knowledge, attitude, practice, health service accessibility.